Four months after a terrorizing and high- profile hepatitis C outbreak linked to hospital drug theft, hundreds of patients who might have been exposed to the liver disease still may not have been tested.

But for the thousands who have tested negative, there is relief: Enough time has passed since the breach that exposure to the virus would have surfaced in blood tests, health officials said.

Rose Medical Center is still trying to track down 375 patients who were in the Denver hospital when surgical technician Kristen Diane Parker, who was infected with hepatitis C, worked there.

Parker pleaded guilty in September to stealing the liquid painkiller fentanyl, then refilling her dirty syringes with saline solution for patients.

Audubon Surgery Center of Colorado Springs, where Parker worked after leaving Rose, has not been able to reach 57 patients.

The patients who haven't surfaced represent a fraction of about 5,700 people the two hospitals set out to test. Rose tested or received test results from private physicians for 4,158 patients, according to the hospital. Of those, 15 contracted the potentially fatal hepatitis C from Parker, genetic testing shows.

About 50 others were found to have hepatitis C that has not been linked to Parker.

Rose is trying to find patients who had surgery from Oct. 21, 2008, to April 13, 2009, in the hospital's main operating room or outpatient surgery center.

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Audubon has test results from 1,167 patients. Although 16 of them tested positive for the disease, none got it from Parker, according to genetic tests.

Three Audubon patients were found to have hepatitis C antibodies in their blood, meaning their bodies fought off the virus. For those patients, there is no way to tell whether they were exposed by Parker, said Brent Ashby, an Audubon administrator.

"We're feeling very confident at this point that none of our patients has been exposed," Ashby said. "We'd like to think that maybe we were doing some good things to prevent her from doing here what she was doing at Rose."

Parker told authorities, though, that she stole painkillers during the seven weeks last spring that she worked at Audubon.

Ashby said the surgery center closed its hepatitis C help line about a month ago and doesn't expect to find the 27 patients who, as far as hospital officials know, never were tested or the 30 additional patients who should have had follow- up testing but did not.

"At this point, we've done just about everything we can to get ahold of all the patients," he said. "We've sent letters. We've made phone calls."

Rose sent certified letters and attempted to call patients in each of the past three months, said Rose communications coordinator Cara Harshberger.

Among the 375 who have not responded are some who refused testing and some who sought testing through a private physician but have not shared those results. Rose does not have current or correct phone numbers for about 100 of the patients.

In response to the outbreak, the Colorado Hospital Association created a task force to investigate hospital "drug diversion" — drug theft by staff, patients or others.

The group is reviewing hospital hiring and drug policies, plus state and federal laws, as it looks for ways to strengthen patient safety, said association president Steven Summer.

Rose also is installing new drug-dispensing machines in its operating rooms and training managers and employees to recognize drug theft, Harshberger said.

Hepatitis C would have shown up in patients' blood six weeks after surgery had they been exposed and if they had submitted to a series of blood tests offered by the hospitals, health officials said.

Parker was arrested in June. She will be sentenced in December, and prosecutors are recommending 20 years in prison.

It can take up to six months after exposure for hepatitis C antibodies to show up in a person's blood. More extensive blood work produces conclusive results after six weeks.

Rose and Audubon each are facing one lawsuit so far as a result of the outbreak.

"This has been a very challenging experience for everybody," Ashby said. "We're certainly glad we're at the end of the road."

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